title: Integration of comprehensive women's health programmes into health systems: cervical cancer prevention, care and control in Rwanda.
abstract: OBJECTIVE
  Although it is highly preventable and treatable, cervical cancer is the most common and most deadly cancer among women in Rwanda.
  
  
  METHODS
  By mobilizing a diverse coalition of partnerships, Rwanda became the first country in Africa to develop and implement a national strategic plan for cervical cancer prevention, screening and treatment.
  
  
  METHODS
  Rwanda - a small, landlocked nation in East Africa with a population of 10.4 million - is well positioned to tackle a number of "high-burden" noncommunicable diseases. The country's integrated response to infectious diseases has resulted in steep declines in premature mortality over the past decade.
  
  
  RESULTS
  In 2011-2012, Rwanda vaccinated 227,246 girls with all three doses of the human papillomavirus (HPV) vaccine. Among eligible girls, three-dose coverage rates of 93.2% and 96.6% were achieved in 2011 and 2012, respectively. The country has also initiated nationwide screening and treatment programmes that are based on visual inspection of the cervix with acetic acid, testing for HPV DNA, cryotherapy, the loop electrosurgical excision procedure and various advanced treatment options.
  
  
  CONCLUSIONS
  Low-income countries should begin to address cervical cancer by integrating prevention, screening and treatment into routine women's health services. This requires political will, cross-sectoral collaboration and planning, innovative partnerships and robust monitoring and evaluation. With external support and adequate planning, high nationwide coverage rates for HPV vaccination and screening for cervical cancer can be achieved within a few years.
authors.affiliation: Ministry of Health of Rwanda, Kigali, Rwanda .
authors.forename: Agnes
authors.initials: A
authors.lastname: Binagwaho
authors.forename: Fidele
authors.initials: F
authors.lastname: Ngabo
authors.forename: Claire M
authors.initials: CM
authors.lastname: Wagner
authors.forename: Cathy
authors.initials: C
authors.lastname: Mugeni
authors.forename: Maurice
authors.initials: M
authors.lastname: Gatera
authors.forename: Cameron T
authors.initials: CT
authors.lastname: Nutt
authors.forename: Sabin
authors.initials: S
authors.lastname: Nsanzimana
mesh_terms: D019058:Community Networks; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D010166:Palliative Care; D011322:Primary Prevention / Q000458:organization & administration; D012432:Rwanda; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D016387:Women's Health